Risk of Retinal Detachment in Patients with Lattice Degeneration☆
Introduction
Retinal detachment associated with lattice degeneration of the retina occurs by two mechanisms, atrophic holes or tractional tears (tears).1 Lattice degeneration is the most frequent lesion causing breaks in nontraumatic phakic retinal detachment.2 On the other hand, the incidence of lattice degeneration in the general population is relatively high, ranging from 8.0 to 10.7% according to previous studies.1, 3, 4, 5 Because the incidence of retinal detachment is as low as 1 in 10,000 per year,2, 6, 7, 8 it is apparent that not all lattice degeneration causes detachment. To manage lattice degeneration properly, it is important to know the risk it carries for retinal detachment. Risk of retinal detachment associated with lattice degeneration is present for virtually a lifetime, making it difficult to evaluate that risk by follow-up of patients with lattice degeneration. Accordingly, there have been few follow-up studies on lattice degeneration to date.9
In 1990, we conducted a survey of rhegmatogenous retinal detachment in Kumamoto, Japan.2 Based on that survey, we statistically analyzed the risk for retinal detachment in patients with lattice degeneration.
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Subjects and Methods
We collected data on hospital patients treated for primary rhegmatogenous retinal detachment in Kumamoto Prefecture in 1990.2 The study was based on a retrospective review of records from the eight hospitals that perform retinal detachment surgery in Kumamoto. Patients with perforative eye trauma, uveitis, diabetic retinopathy, or subclinical detachment were excluded. Of the patients, 70% were diagnosed by six ophthalmologists at the Ideta Eye Hospital, and the remaining 30% by at least two
Results
In 1990, there were 192 patients with retinal detachment; 180 were nontraumatic phakic, 9 were aphakic, and 3 were detachments caused by blunt trauma.2 In 109 of the 180 patients with nontraumatic phakic detachment, the predisposing lesion of retinal break was lattice degeneration. We did not include patients with lattice degeneration in whom no break was observed in the areas associated with lattice degeneration, and in whom breaks occurring in another lesion had caused retinal detachment (one
Discussion
Kumamoto Prefecture is located in southwestern Japan. Patients with retinal detachment in Kumamoto can be treated at eight hospitals, all of which participated in this study. The incidence of retinal detachment in Kumamoto in 1990 was 10.3 per 100,000 population.2 This incidence was similar to that of nontraumatic detachment in Iowa investigated by Haimann and colleagues6 in 1976 (11.4), in Israel investigated by Michaelson and colleagues7 in 1968 (10.8), and in Rochester, Minnesota,
Acknowledgements
(List of participating hospitals, showing number of patients enrolled in this study from each hospital.)
Ideta Eye Hospital, Kumamoto City, Kumamoto (131 patients): K. Sasaki, MD; H. Ideta, MD; J. Yonemoto, MD; S. Tanaka, MD; A. Hirose, MD; C. Oka, MD.
Kumamoto City Hospital, Kumamoto City, Kumamoto (11 patients): Y. Nomura, MD.
Kumamoto Red Cross Hospital, Kumamoto City, Kumamoto (7 patients): T. Shimizu, MD.
Kumamoto University, Kumamoto City, Kumamoto (34 patients): Y. Kojima, MD.
Kurume
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Presented at the 96th AAO meeting in Dallas, Texas, 1992.